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Pregnancy

breech baby

13 replies

mumnanny1 · 02/12/2008 21:34

Does anyone have any experience of having a baby turned or of having a breech vaginal birth? I am 34 wks and considering all options as this baby doesn't seem to want to turn!

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thisisyesterday · 02/12/2008 21:40

i know a few people whose breech baby turned at around 34 weeks or a bit after, so you never know!

i know ecv doesn't have a huge success rate and can be quite painful.

have you googled mary cronk? hands off the breech
several mn'ers have had vaginal breech birhts, hopeuflly some of them are on tonight

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gothicmama · 02/12/2008 21:44

I had breech baby luckily in a suitable position for vaginal delivery, be prepared and brief your birth partner about whatyou want in various situations, Mary Cronk is very good and I wished I had read it before mine. ECV could not be done because not enough liquid or room.On another note my last pregnacny baby was breech until 38 weeks then turned.

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mumnanny1 · 02/12/2008 22:03

Thank you lots. will definitely google Mary Cronk.Gothic mama- Can I ask how the delivery went?

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Tangle · 02/12/2008 22:26

Is it your 1st baby? Have you tried anything to encourage you LO to turn?

DD was palpated as breech from 28 weeks, confirmed by scan at 35 weeks and born as a breech baby at home at 41+3 with IMs.

We did a lot of reading after the scan and came to the conclusion that a vaginal breech birth is not intrinsically dangerous as long as you have MWs skilled and experienced in vaginal breech birth. That, sadly, is often the stumbling block for women that would like to try to birth their breech babies vaginaly - NHS policy of recommending CS for breech babies (mainly based on a piece of research called the "Term Breech Trial" by Hannah et al in 2000, which has subsequently been widely discredited) has resulted in a massive deskilling of MWs and there are few left within the NHS that have the skill or any recent practice.

That said, something like 5% of babies are breech at term and 50% of those are undiagnosed before labour - so at least some breech babies are born vaginally. Even though some of those will become medicalised deliveries, some will still be MW led births (if only because there isn't time for the Drs to arrive before the baby is born!).

Two books I found very useful were "Breech Birth" by Benna Waites and "Breech Birth: What are my options" by Jane Evans. I found them both to be approachable and informative, and felt they were far more balanced than the information I got from the NHS registrar (who didn't even mention vaginal breeches till I asked, and didn't seem to know about vaginal breech births at all...). The Benna Waites book in particular has a chapter on complementary methods of encouraging your baby to turn that you might want to have a look at.

If you are interested in vaginal breech birth, make sure you (and anyone else involved) are very clear on the distinction between a breech birth and a breech delivery - Mary Cronk (who is probably the UK expert on vaginal breech birth) sums it up quite nicely in this article. As has been said, googling Mary Cronk in general is also well worth doing.

ECV success rates are, on average, 50%. There is a very small chance that the procedure may cause the baby distress to the point it needs to be delivered immediately by CS, and so an ECV should only be performed in a hospital with a theatre - but it is a very small risk. Success rate will vary with the skill/experience of the practitioner and with the position of the baby, so ask a lot of questions before deciding - if your baby is in the right position and you have a skilled Obs the chance of them turning could be a LOT higher. Different women report the experience as anywhere between mildly uncomfortable and extremely painful - if you do decide to go for it remember you can tell (not ask ) them to stop at any point if you decide it feels wrong.

If you want to consider vaginal breech birth within the NHS you'll probably have a fight on your hands. As soon as you're flagged as breech you get shunted into consultant led care and will be treated as "abnormal" (probably best solved with a scalpel). Few consultants will have the knowledge to talk about vaginal breech birth, as they are unlikely to have seen it. NICE guidelines recommend against it, and the main reason they quote is lack of MW skills. Best bet is to get an appointment with the Head of Midwifery and dicuss the situation with her - she may have breech skills in house and be happy to use them. Failing that you could write a letter to the Head of Midwifery and the head of your PCT stating you intend to birth your baby vaginally and you expect them to provide MWs with suitable skills - depends how resiliant your feeling. I have heard of a PCT paying for an IM with breech skills so its not unheard of...

We were planning a home birth before the whole breech issue became concerning. We'd lost confidence in my CMW and were considering IMs anyway - so we just made strong breech skills a fundamental criteria. Its certainly worth calling some IMs local to you and seeing what they say - most will be more than happy to talk through the options and, may have local knowledge on how your PCT have reacted previously. You can find them here (and most will be more than happy to do that whether you book them or not).

And lastly (sorry - I've done another essay ), your baby is still more than likely to turn of their own accord. And if they don't there is no single right way to get them into the world alive whatever anyone says: all you can do is choose the set of risks that you feel is best for you and your family and take it from there.

Good luck deciding (but fingers crossed they turn)

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gothicmama · 03/12/2008 12:23

I was in a consultant led unit but they were very understanding and although at one point they want me to have an epidural just in case by the time the woman had come to do this I was fully dilated and pushing the worst bit for me was having my legs in stirrups fortunatly all went well, i think in part to dh being able to let everyone know what I wanted DD was born after 7 hours labour and had to go in a heated cot overnight also we had to have vitk injection because she was breech and she had bruised bottom. It was no more painful than subsequent labours. Be prepred tho for any student doctors to pop in as it rare occurence to be honest tho it was good having two doctors as well as the midwifes. I did not discus with anyone prior but I notified them on teh phone when I phone tho to say I was coming in

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mumnanny1 · 05/12/2008 21:47

Tangle - Thankyou so much for all that information, it's fantastic. Thanks also Gothic mama, so glad everything went well in the end for you. It's all very encouraging. This is my second baby, the last one was the 'normal' way up throughout! I get the feeling one of my midwives is keen for me to have a vaginal delivery whatever, but the other seems very nervous and has said I will just have to discuss options with a consultant. I have got to wait until the 17th to have a scan confirming just what position baby is in. Midwives have seemed to find it impossible to figure it out. I am still hoping that the baby will turn by itself, one of my midwives didn't seem to optimistic though. She told me not to hold my breath!

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MrsJamin · 05/12/2008 21:56

if this is your 2nd baby chances are your baby will turn and if you have an ECV, it has more chance of being successful - your midwife should be more optimistic! DS was breech and I had him on emergency c-section after a failed ECV then brought on labour a few hours later. The lack of confidence in the hospital to deal with a breech birth meant I had no confidence to do it either. You're still early on and if you do things like being on all fours for a while with your bum in the air, your baby may turn of his/her own accord - good luck with it all!

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mumnanny1 · 05/12/2008 22:06

Jamin, thanks. I'm definitely going to try bum in the air and maybe some reflexology too! Didn't know ecv could bring on labour. Scary!Good to be informed of all the possibilities though. The way I feel currently the sooner baby is born the better!

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MrsJamin · 06/12/2008 09:12

mumnanny1, I tried reflexology, I thought it was a bit of a rip-off at £40+ so I would recommend buying some moxa sticks from a chinese herbalist and doing it yourself! It's mega early days though and IIRC something like 15% of babies are breech at 32-34 wks yet only 2-3% will still be breech at term - that means you've only a 1 in 5 chance that your baby won't turn and I'm sure the stats are more favourable if it's not your first pregnancy. I'm not sure whether the ECV brought on labour, as I was 39+5, but it was only 8 hours later my waters broke. They advise you to bring your hospital bag with you (leave in car) if you have an ECV. It was INCREDIBLY painful (more painful than contractions at 6+cm!) but I'm glad I gave it a go - others find it's just uncomfortable.

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ShirleyL · 07/12/2008 14:19

hi mumnanny1 just wanted to tell you that my baby was head down until my 34 week scan where they told me it had turned and it was breech. At my 36 week appointment it was still breech then at the 37 week scan it was back to being head down. This is my second baby as well. I did lots of kneeling on all fours, bum in air and positive thinking.
I was in your position a few weeks ago so know what your going through, discussing options etc. Good luck

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Iloveautumn · 07/12/2008 15:51

Hi - just to let you know my ds was breech at 32 weeks and turned some time after that - not sure exactly when, but he had def turned by 36 weeks. (first baby).

(I'm now 31 weeks with #2 but pretty sure this one is head down!!)

Good luck

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BikeRunSki · 07/12/2008 15:57

A word of warning... my baby turned into breech posistion at about week 35! Was born by eme cs as undiagnosed footling breech - not diagnosed until I was 8 cm dilated.

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mumnanny1 · 07/12/2008 22:11

Thanks everyone. I am feeling more positive about the baby turning of its own accord. Lots of people have told me about late turners. Fingers crossed!

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